Sulfonylureas Flashcards
Give examples of common sulfonylurea drugs.
Glipizide, glibenclamide, gliclazide, glimepiride, tolbutamide.
How do sulfonylureas act to exert their therapeutic effect?
Stimulates beta-cell insulin secretion in the pancreas and so reserve beta-cell function. With time the beta-cell function declines, leading the drug efficacy to become suboptimal.
In what patient group are sulfonylureas not recommended? Why?
The elderly due to risk of hypos.
What are some side effects associated with the sulfonylureas?
Weight gain, rarely hepatic dysfunction, hypersensitivity reactions 6-8 weeks from initiation, blood disorders.
Can the sulfonylureas be used in pregnant and breastfeeding mothers?
No.
Which sulfonylurea can be used, unlicensed, to treat gestational diabetes in the third trimester of pregnancy?
Glibenclamide.
Sulfonylureas may cause hypoglycemia which can persist for many hours, how must this be treated?
Always in hospital.
When is the risk of hypoglycemia with sulfonylureas increased?
When used in combination with other glucose lowering drugs.
Describe the effect sulfonylureas can have on a patients weight?
May promote weight gain.
Which sulfonylurea is preferred in the elderly?
Gliclazide.
Which sulfonylurea can be used in significant renal impairment? Why?
Gliclazide. It is metabolized mainly in the liver.
What counselling should be provided to patients on sulfonylureas?
The risk of hypos, the symptoms of a hypo, never to miss meals, always carry a source of fast acting sugar in case of a hypo.
What are the symptoms of a hypoglycemic event?
Weakness, confusion, sweating, slurred speach, aggression, fits, loss of consciousness, palpitations.
